An estimated right ventricular systolic pressure >30.0 mm Hg was associated with significantly increased mortality compared to the lowest quintile (HR 1.410; 95% CI 1.310-1.517; p<0.001).
Cohort (n=157,842)
Yes
Does an estimated right ventricular systolic pressure (eRVSP) >30.0 mm Hg increase mortality in a general echocardiography cohort?
An eRVSP >30.0 mm Hg is identified as a distinctly lower threshold for increased mortality risk indicative of pulmonary hypertension compared to currently accepted levels.
Hazard Ratio: 1.41 (95% CI 1.31–1.517)
p-value: p=<0.001
BACKGROUND There is increasing evidence that current thresholds for diagnosing pulmonary hypertension (PHT) underestimate the prognostic impact of PHT. OBJECTIVES The aim of this study was to determine the prognostic impact of increasing pulmonary pressures within the National Echocardiography Database of Australia cohort (n = 313,492). METHODS The distribution of estimated right ventricular systolic pressure (eRVSP) was examined in 157,842 men and women. All had data linkage to long-term survival during median follow-up of 4.2 years (interquartile range: 2.2 to 7.5 years). RESULTS The cohort comprised 74,405 men and 83,437 women 65.6 ± 17.7 years of age. Overall, 17,955 (11.4%), 7,016 (4.4%), and 4,515 (2.9%) subjects had eRVSP levels indicative of mild (40 to 49 mm Hg), moderate (50 to 59 mm Hg), or severe (≥60 mm Hg) PHT, respectively, assuming a right atrial pressure of 5 mm Hg. These subjects were more likely to die during long-term follow up (for severe PHT, adjusted hazard ratio: 9.73; 95% confidence interval: 8.60 to 11.0; p 30.0 mm Hg) indicative of PHT was identified. (A Longitudinal Cohort Study of Echocardiograms From Public and Private Echocardiography Laboratories From Around Australia, Linked With the National Deaths Index; ACTRN12617001387314).
“Our unique findings suggest that those currently considered to be at intermediate risk for underlying PH have a significant risk for mortality once they reach the threshold of eRVSP [higher than] 30.0 mm Hg. Future studies should characterize patients with borderline PH on the basis of eRVSP to determine the mechanisms of excess mortality, and evaluate the efficacy of therapeutic interventions to prolong survival.”
Strange et al. (Mon,) conducted a cohort in Pulmonary hypertension (n=157,842). Estimated right ventricular systolic pressure (eRVSP) >30.0 mm Hg vs. Lowest quintile of eRVSP was evaluated on Mortality (HR 1.410, 95% CI 1.310-1.517, p=<0.001). An estimated right ventricular systolic pressure >30.0 mm Hg was associated with significantly increased mortality compared to the lowest quintile (HR 1.410; 95% CI 1.310-1.517; p<0.001).